Are there any drivers with 6 points or more on their license or any drivers who have had a driving ban in the last 5 years?

Yes

No

If yes, give details of the driver and the convictions

Do the Vehicles carry any hazardous Goods?

Yes

No

Please give details

Do the Vehicles visit any Hazardous locations

Yes

No

Please give details

CLAIMS HISTORY

We will require a three year written confirmed claims experience from your existing and or previous Insurers. However it would help to have as much information as possible in the box giving dates, circumstances and costs of any claims in the last three years